Context:Laryngeal mask airway (LMA) Classic™ has an inflatable cuff while i-gel™ has a noninflatable cuff made of thermoplastic elastomer.Aims:To compare ease of insertion, number, and duration of insertion attempts among the two device. Secondary objectives were to evaluate the hemodynamic response and SpO2 during device insertion and during maintenance of general anesthesia.Settings and Design:This study was conducted as randomized observational study in a teaching hospital.Subjects and Methods:One hundred American Society of Anesthesiologists I and II, patients posted for surgery under general anesthesia were divided in two groups of fifty each. LMA Classic™ and i-gel™. Ease of insertion, duration of insertion, hemodynamic data, and episodes of hypoxia during insertion, 1, 3 and 5 min for 30 min, during removal and 1 min after removal.Statistical Analysis Used:Descriptive analyses were expressed as a mean ± standard deviation. Independent t-test used for parametric data, Chi-square test for nonparametric data and hemodynamic data were analyzed using repeated measures ANOVA to find statistical difference within the groups.Results:Devices were easy to insert, the mean duration of insertion attempts was 15.92 ± 1.62 s in the i-gel™ group, while it was 26.06 ± 5.12 s in the LMA Classic™ group, was statistically significant (P = 0.0001).Conclusions:Successful and shorter duration of insertion, with less hemodynamic response makes i-gel™ a suitable alternative to LMA Classic™ during general anesthesia.

Background:Various analgesic modalities have been used for postoperative analgesia in patients undergoing inguinal hernia surgery. In this randomized clinical trial, we have compared the analgesic efficacy of transversus abdominis plane (TAP) block with that of ilioinguinal/iliohypogastric (IIIH) nerve block with wound infiltration in patients undergoing unilateral open inguinal hernia repair.Aim:The primary objective of this study was to compare the efficacy of postoperative analgesia of ultrasound-guided TAP block and IIIH block with wound infiltration (WI) in patients undergoing open inguinal hernia surgery.Settings and Design:This was a randomized clinical trial performed in a tertiary care hospital.Materials and Methods:Sixty patients scheduled for hernia repair were randomized into two groups, Group T and Group I. Postoperatively, under ultrasound guidance, Group T received 20 ml of 0.25% ropivacaine – TAP block and Group I received 10 ml of 0.25% ropivacaine – IIIH block + WI with 10 ml of 0.25% ropivacaine. The primary outcome measure was the time to rescue analgesia in the first 24 h postoperatively. Fentanyl along with diclofenac was given as first rescue analgesic when the patient complained of pain.Statistical Analysis:Statistical comparisons were performed using Student's t-test and Chi-square test.Results:Mean time to rescue analgesia was 5.900 ± 1.881 h and 3.766 ± 1.754 h (P < 0.001) and the mean pain scores were 5.73 ± 0.784 and 6.03 ± 0.850 for Group TAP and IIIH + WI, respectively. Hemodynamics were stable in both the groups. One-third of the patients received one dose of paracetamol in addition to the rescue analgesic in the first 24 h. There were no complications attributed to the block.Conclusion:As a multimodal analgesic regimen, definitely both TAP block and IIIH block with wound infiltration have a supporting role in providing analgesia in the postoperative period for adult inguinal hernia repair. In this study, ultrasound-guided TAP block provided longer pain control postoperatively than IIIH block with WI after inguinal hernia repair. There were no complications attributed to the blocks in either of the group.

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Anesthesia for emergency cesarean section for the pregnant patient with surgically corrected scoliosis is associated with potential risks for both mother and the fetus due to alterations in maternal physiology and the pathological changes seen in scoliosis. The anesthetic management must address the well being of both mother and fetus. The need for anesthesia for obstetric delivery in pregnant women with scoliosis is much more than in the normal parturient. We report the successful use of spinal anesthesia in a patient with surgically corrected scoliosis for emergency cesarean section.

Introduction: Ultrasonography (USG) guided supraclavicular block is an excellent choice for upper limb surgeries. It not only allows smaller volumes of local anaesthetic usage but also provides optimal tourniquet coverage. Ropivacaine is structurally related to bupivacaine with reduced potential for toxicity and improved sensory and motor blocking profiles. Nalbuphine acquired a significant place in pain control but its efficacy as a local anaesthetic adjuvant is yet to be proved in peripheral nerve blockades. Aim: To evaluate the efficacy of adding nalbuphine to ropivacaine in supraclavicular brachial plexus blockade and to assess the quality of block for patients undergoing ambulatory forearm and hand surgeries. Materials and Methods: Seventy American Society of Anesthesiologists (ASA) grade 1 and 2 patients were randomised into two groups of 35 each. Group A (n=35): received 24 mL of 0.5% of ropivacaine + 1 mL of nalbuphine (10 mg) and Group B (n=35): received 24 mL of 0.5% of ropivacaine + 1 mL of normal saline. The parameters observed were duration of analgesia, onset of sensory and motor blockade, duration of motor blockade and haemodynamic changes during the procedure. Categorical variables were analysed using the Pearson’s Chi‑square test. Continuous variables were analysed using the independent sample t‑test and p<0.05 was considered as statistically significant. Results: The onset of sensory and motor blockades were faster in the nalbuphine group compared to the control group (p<0.001). The duration of sensory and motor blockades was similarly longer in nalbuphine group (p<0.001). Also, the mean duration of analgesia was significantly longer with nalbuphine group (p<0.001). Conclusion: Nalbuphine significantly prolonged the duration of analgesia and duration of block while accelerating the onset of blockade thereby improving the overall quality of blockade.